Is American Medicine Racist And Sexist?

January 16, 2001

One increasingly hears the charge that a white, male medical establishment is short-changing women and blacks in medical care. But psychiatrist Sally Satel, author of the forthcoming book "P.C., M.D.: How Political Correctness Is Corrupting Medicine," says such charges do not hold up under scrutiny.

While studies have found that certain diagnoses are made, and preventive tests or therapeutic procedures are performed, at differing rates among women and minorities compared to white males, she cautions that explanations other than racism or sexism should be considered.

Variation in medical care may relate to differences in those groups' utilization of the health system and health differences in various population groups, rather than any denial of access to care. For example:

Overall, African-Americans are less likely to be routinely screened for cancer -- but they are also less likely to submit themselves for regular check-ups.

Hypertension, or high blood-pressure, is more likely to afflict black Americans than whites -- which might be explained by differences in diet, as well as genetic predisposition.

Uterine fibroid tumors and hysterectomies are more common in black women than in white women -- but osteoporosis-related fractures, and thus hip-replacements, are rarer.

Limb-amputation is more common among black patients -- sometimes because thicker atherosclerosis in the leg makes it harder to perform limb-saving surgery.

African-Americans suffer strokes at higher rates than whites. Yet the former are much less likely to undergo carotid endarterectomy to unclog arteries in the neck. That's because whites tend to have obstructions in regions readily accessible to surgery. But blacks often have blockages in areas where surgery is riskier.

Source: Sally Satel (Yale University School of Medicine), "The Indoctrinologists Are Coming," Atlantic Monthly, January 2001.